By Dr Ananya Mandal, MD
Prognosis of a disease is defined as the outcome or the expected course of the disease. It comes from an ancient Greek word that means ‘to know beforehand’.
At present there is no cure for AIDS and it is fatal without treatment. HIV infection, however, takes a very long time to develop into full blown AIDS. The virus begins to replicate in the body within the CD4 cells and begins to destroy the immunity.
The time taken for development of AIDS from HIV infection may range from 6 months (very rare) to 15 years. In the UK the average time to development of AIDS from initial HIV infection is around 12 years.
Delaying the onset of AIDS
Beginning anti retroviral therapy after detection of HIV positive status helps in delaying the onset of AIDS and related conditions. These drugs prevent the viral replication and do not actually cure the disease.
In the U.S., most patients survive many years after diagnosis because of the availability of highly active antiretroviral therapy (HAART). HAART has dramatically increased the amount of time people with HIV remain alive.
What affects the prognosis of HIV/AIDS?
Factors that affect the outcome of people with HIV include:
CD4 cell count. Lower counts indicate a poor immunity and chances of getting infections that may often turn life-threatening.
Viral load in blood. High number of viable viral RNA in blood is another indicator of poorer prognosis.
Age of the patient. Infants and elderly are more at risk of a poorer outcome and rapid progress of the disease.
Those who have developed a serious HIV related condition before starting the anti-HIV medication are also at a high risk of early AIDS progression and death.
Concomitant infections with hepatitis B or C virus
Injectable drug abusers
Those with heart disease or liver disease often have a poor prognosis as well.
HIV vaccine development
Over the past three decades an effective vaccine against HIV has been researched. As of date no effective vaccine against the disease has been found. Research on drug treatments and vaccine development continues.
HIV status in developing countries
HIV medications are not always available in the developing world, where most of the epidemic is raging.
Factors that have improved prognosis of HIV infection in developed countries like US and UK
The most important factor is HIV medication availability. The amount of illness and death caused by HIV has fallen dramatically since powerful combinations of anti-HIV drugs became available in 1996. In addition, routine screening and early detection has also facilitated early institution of anti retroviral therapy and has improved prognosis.
A longer and healthier life can also be possible with regular checkups at HIV clinics, taking regular HIV medication and other medications, not smoking, eating a healthy balanced diet and exercising regularly. Maintaining a healthy mental status is also important.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)